An Interview with Felix Chung
Felix Chung, President of MIST, IMILLING, and DOF USA, says using CAD/CAM for in-house production of implant prosthetics is the key to the future.
Inside Dental Technology: What challenges and trends are affecting laboratories?
Felix Chung (FC): I believe the biggest challenge for today’s dental laboratories is turning a profit on the prosthetic products they sell to dentists. The current downward pricing pressures for single-unit crowns and the costs associated with ownership of scanners, milling machines, and other CAD/CAM equipment, which some laboratories are challenged to afford, can adversely impact profitability. Often, laboratory owners must either take out a loan to purchase CAD/CAM equipment or outsource that work, both of which can significantly cut into profitability. The exception is implant prosthetics, which tend to be far more profitable.
A laboratory can successfully partner with a great milling center to offer a very affordable prosthetic, or manufacture that same prosthetic in-house to achieve an even more profitable investment. That offers laboratories a huge profit potential. With a growing demand for implants, I envision more laboratories will offer their clients implant prosthetics regardless of whether they keep the production in-house or partner with milling centers.
IDT: What are the advantages and risks for producing implant prosthetics in-house?
FC: The biggest advantages are maximizing profitability and meeting future industry demands. In the next 5 years, the demand for implant prosthetics is projected to increase rapidly. If laboratories want to help meet that rising demand and capture a sizable piece of that implant prosthetic pie, they absolutely will need to bring the production of implant prosthetics in-house. I do not see any other reasonable solution. Added to the increased demand will be additional pressures from dentists for shorter turnaround times and customization. In-house production allows the laboratory to retain 100% control of fabrication processes and to deliver on these added demands. That being said, to make that big leap and investment, the laboratory also must ensure its technicians have the expertise, training, and stringent quality controls in place to guarantee delivery of a product that meets rigorous FDA standards. Not only is it necessary to be able to sell it to the customer, you also must produce a better prosthetic than the implant companies offer. That is a challenge in itself, because the implant companies produce very high-quality products. However, I see this trend as a necessary risk if the smaller laboratory, in particular, is to remain viable.
IDT: When a laboratory is developing its digital capabilities, what role does an equipment vendor play?
FC: The vendor must offer customers complete support in regard to every aspect of equipment usage and workflow. To start, a vendor should assess the laboratory’s needs and budgets, and then provide recommendations on which equipment is most appropriate. You need to consider that there still may be many laboratories that have never designed anything using a computer. The process of migrating toward digital is difficult, complex, and challenging. The wholesale shift in the company’s workflow is also incredibly disruptive. Then, there is the pressure of a huge financial burden for purchasing the equipment. So a vendor must offer sound advice and every support service possible—whether it relates to education, installation, designing, and scanning a case or troubleshooting in the event of an equipment malfunction. Finally, a vendor should have a solution in place that allows the laboratory to continue operating without interruption should the equipment break down.
IDT: In addition to robust customer support, what should a laboratory consider when buying CAD/CAM equipment?
FC: First, only buy equipment that will make your company more profitable. Purchase equipment that allows you to handle your current product offerings. Then upgrade to handle more technically demanding fabrications as you become more experienced. The 2 most significant benefits of CAD/CAM equipment are faster turnaround times and full control over production processes. So your equipment selection must match your current needs and goals. If you are looking to produce a screw-retained zirconia implant crown, you need to look for equipment that has the necessary CAM software and milling strategies. Or are you looking for equipment to mill just zirconia crowns? It comes down to knowing what types of prosthetics you want to produce. Next, look for equipment that is fully open. This will provide the flexibility to select and integrate the scanners, CAD software, and milling units best suited for your laboratory. Also consider costs. Higher prices do not necessarily mean better performance. Some more affordable CAD/CAM products deliver quality prosthetics as good as, or better than, more expensive systems. Finally, when buying milling blocks, it is best to stick with well-established materials, avoiding those that lack FDA approval or sufficient clinical research data.